HomeMy WebLinkAbout07100192 Applicationtv o? tgry??
071
City of Carmel/Clay Township Permit #:
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: PHONE: FAX:
(3
)3
4311?
OF i 3 17
Y7_
RECORD: STREET ADDRESS:
&L50 TrlEcom - sD e W0 1 CITY:
n STATE:
J:s TN ZIP:
yWa 8
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
bik
PROPERTY NAME: PHONE FAX:
31 7
OWNER
:
STREET ADDRESS:
0 Tekcom E S ' E CITY:
I Q STATE:
/'S I ZIP:
g6a79'
LOCATION LOT #: SUBDMSION MfE:
41 ?(77 ?My7 c
g
111J rrp N: ZONING:
S
& PROJECT S LEST
A
I
INFO: ADDRESS OF CONSTRUCTION:
bidf-
1
h
OCT
2 9 2007 SQUARE
FOOTAGE:
J /7J
SEWER UTILITY WATER UTILITY ESTIMATED COST OF ON UCTION:
?
PROVIDERJt T PROVIDER:
:
C
d
R
I
By
(EXCLUDING LAND V
LUE)
'100
! O O
O?
c
A
M o
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
(IF APPLICAB
OR SEPTIC PERMIT t
D LE): T
5
/
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AN
rrl?
J
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL
FOR THIS PROPERTY:
TYP F CONSTRUCTI N: TYPE F IMPROVEME Y0 S $ (PLUMBING CONTRACTOR:
SINGLE FAMILY NEW STRUCTURED n -rv di Q S '
O TOWN HOME ? ROOM ADDITION O
m p umber's Indiana State License
? TWO FAMILY ? _
PORCH ADD S "= U
k of units being = DECK ADDIT OM g n D :V101777
constructed at this n REMODEL D G. ro m
plumbing codes will be applied to the construction:
t
time: l.Z
Basementnikh O o f
? RESIDENTIAL (For
l
Et
) C3 _
_ International Residential Code w/Indiana Amendments
ACCESSORY B
l)31-
ETACHED GARA n
s,
c.
Additions. Remode ? p
D
Uniform Plumbing Code w/Indiana Amendments
o
PROJECT INFORMATION: ?
?
.
ATTACHED GARAGE-,
DEMOLITION C) M Ja m
?OUNDATION TYPE: (Check all that apply for the new
m '
,
Early Release /
? Manufactured Z (- ,' --Construction area)
Cl
? POST & BEAM PIER
O Q
Permit: Y L
Trusses:
O CRAWLSPACCE
?
z
Lot Split: Y v N Sump N )
Pump:
Y O SLAB /BASEMENT (WALKOLJT:_Y
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is Valid only if construction commences within 160
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 LAC 12) regarding expiration time frames for beginning and
completing construction.
1, the undersigned, agree that any construction, reconstruction, erlargemeat, relocation, or alteration of a s-ructure, or any change in the use of land or structures
requested by this application will comply with. and cenfom to, all app':itable laws of the State of Indiana, and the °Zoaniz Ordnance o`. Cannel Indiana -1993' (.--
289) and amendments, adopted under authority of I 36-7 at seq, General Assembly of the State of Indiana, and al! Acts amendatory thereto. 1 further certify that only
kitchen, bath, and door drains are connected to the sanitary sewer. I further certify that the construction rill not be used or occupied until a Certificate of
Acupancyhas been issued by the Department of Community Services, Carmel, Indiana.
LOOZ; A. Bi&U-10ASG-NEti 1'PJE - 101/,25167
?a ?,Aa tt?_,y MO,
Signature of owner or Authorized AA Qt Print Date
OFFICE USE ONLY:zs:....s. :........*****act*a:V=------------------ _2___ __.....
J .......
Filing Fees:
SPECTIO _QUIRED:
_ S # Charged Re
Upper Footin Lower Footing Slab Base Inspections:
iO Reviews
Cert. of Occupancy:
Rough In Meter Ba in Site
P.R.I.F.: a
CIO
Additional Fees
3d
TOT -
Reviewed/Approved: Dept, of Community Services (Date) G?
S:PermlWFOrnS'1LP .^+ESIDEIRLIL cea ate